Lindsey Ann Rudolph
Individual provider Active NPI Pharmacist · La Conner, WA
NPI 1487328654 · NPPES record last updated Aug 2, 2021
Key facts
- NPI
- 1487328654
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH61077394 (WA)
- Practice address
- 708 East Morris Street
La Conner, WA 98257 - Phone
- (360) 466-3124
- NPI assigned
- Aug 2, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH61077394 | WA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH61077394 | WA | Yes |
Addresses
Primary practice location
708 East Morris Street
La Conner, WA 98257
Mailing address
708 East Morris Street
La Conner, WA 98257
Phone (360) 466-3124
Other providers in La Conner, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.